December, 2005:

Smoking is bad for health, as is the inhalation of secondhand smoke (SHS) from other people’s cigarettes. There is now an extensive body of medical evidence, established over the past 30 years, that SHS contributes significantly to the risk of a range of diseases, from cot death, glue ear and respiratory disorders in children to lung cancer and heart disease in adults. WHO, the US Surgeon General and SCOTH have concluded that SHS is a preventable cause of death and ill health. The Royal College of Physicians produced a report in July 2005, entitled Going smoke-free: The medical case for clean air in the home, at work and in public places, in which it summarised the evidence of the damage done by SHS. It is currently estimated that SHS causes at least 12,000 deaths each year in the United Kingdom. 500 of these deaths are due to smoke in the workplace.

There is no satisfactory way of allowing smoking in public and at the same time protecting non-smokers from the harmful effects of SHS. Ventilation, while technically feasible, is not a practical approach since the equipment necessary would be extremely expensive and would not be suitable for use in public places, such as licensed premises, where there are some of the highest levels of exposure to SHS. The only sensible way to afford protection from SHS exposure is to implement a comprehensive ban on smoking in public places and workplaces.

Many countries and states have taken the decision to legislate against smoking in public. The most prominent example is the Republic of Ireland, where there has been a popular and effective prohibition on smoking in public places and workplaces since March 2004, but similar restrictions are in place in (among other places), South Africa, Thailand, Australia, New Zealand, India, Norway, Italy, Vietnam, and parts of the United States of America including California, New York, Delaware and Florida. In addition, a comprehensive ban on smoking in public will be introduced in Scotland in March 2006, while the decision to implement a ban has been taken in principle in Northern Ireland.

The primary justification for a ban on smoking in public places and workplaces is that it protects workers and other vulnerable groups from the significant health risks which SHS poses. The Irish experience suggests that the consequences for smokers will be slight. Pubs will survive and smokers seem happy using outdoor smoking areas. Smoke-free legislation is also likely to have an impact on overall smoking prevalence, and it sends a powerful public health message about the dangers of smoking.

The Government, after consulting with the public, presented its plans for a ban on smoking in public places in the Health Bill, published in October 2005. It plans to treat public places which are also dwellings differently from other public places. While the consultation seems to have envisaged that prisons and military premises would be included in the legislation, they are not part of the Bill as published. We discovered with some difficulty that the provisions of the Bill do not extend to Crown property. We are disappointed that none of a host of Government witnesses to the inquiry informed us of this important fact. Although not covered by the ban, the MOD intends to keep within the spirit of the law. The Prison Service will move in the same direction but emphasised the huge difficulties it faced. We are concerned that this will be an excuse for inaction. We recommend that target rates be set for penal institutions, MOD premises and psychiatric institutions to become smoke-free.

Under the proposed legislation, exemptions are also provided for licensed premises in which food is neither prepared nor served and membership clubs. The Government has sought to defend its proposals on the grounds that public opinion is not yet ready to accept a comprehensive ban and so there would be problems with compliance. The Minister for Public Health told us that bar workers would be protected by a one-metre exclusion zone round the bar, but under questioning admitted that would provide no health benefits. The previous Secretary of State for Health, Rt Hon John Reid MP, told our predecessor Committee that that under the Government’s proposals few bar workers would die. He also argued that such a ban would lead to an increase in smoking in the home. The Government has now admitted that he was wrong.

The Government’s contention that a ban on smoking in all pubs and clubs would be unpopular is disputed. The White Paper Choosing Health is confusing and possibly misleading on the subject. Moreover, since its publication opinion has been moving rapidly in favour of a comprehensive ban. The latest survey indicates that around 70% of the population support such a ban.

The evidence we have considered compels us to conclude that the only effective means of protecting all workers from the harmful effects SHS is a comprehensive ban on smoking in enclosed public places and work places. We therefore agree with the Chief Medical Officer that a failure to implement such a ban would put England “among the laggards of public health”.1

We recommend that the Government introduce a comprehensive ban on smoking in all public places and workplaces, which includes Crown property and which has very limited exemptions. This is primarily an issue of protecting workers in the workplace, and all employers have a duty of care in this regard. It is unacceptable for the Government to allow any worker to be excluded from protection from SHS on the grounds of public opinion, especially when these grounds are specious. Moreover, a comprehensive ban would be easier and more cost-effective to implement and enforce, and would be more intelligible to the public. The ban introduced in Ireland has been a popular model which the UK Government would do well to follow.